自体骨髓移植治疗恶性肿瘤和白血病12例临床分析

Clinical analysis of 12 cases of malignant solid tumor and acute leukemia with ABMT treatment

目的分析我院自体骨髓移植治疗恶性肿瘤和白血病的疗效。方法8例恶性肿瘤和4例白血病经术前减瘤治疗或巩固强化后,采用联合化疗为预处理进行自体骨髓移植。结果12例病人采髓量为520～1000ml,采集骨髓有核细胞数为(0.11-2.07)×108/kg,回输骨髓活细胞率为61%～99%。除1例患者造血延迟恢复外,所有患者均移植成功,无移植相关死亡。平均住舱时间为30d,出舱时恶性肿瘤和白血病均达完全缓解。移植后12例中近期复发3例,远期复发2例,2例实体瘤和1例白血病分别于移植后8、14个月和15个月并发其他恶性肿瘤或血液病。复发率为42%,总生存率30%(生存期平均为7.5±5.1年)。结论自体骨髓移植治疗恶性肿瘤和白血病的近期疗效较好,但复发率较高,且应警惕移植后并发第二肿瘤的危险。

Objective The therapeutic effect of autologous bone marrow transplantation (ABMT)in treatment of malignant solid tumor and acute leukemia was analyzed.Methods After reducing tumor mass through radio -chemotherapy,ABMT were performed in solid tumor(8cases)and acute leukemia(4cases).Re sults The volume of BM collected was520～1000ml;The number of Myeloid nucleated cells(MNC)(0.11～2.07)×10 8 /kg.The vital MNC infusion were61%～99%.All the patients,ex-cept one with delayed hematopoietic reconstruction,were successfully transplanted.The mean hospitaliza-tion time was30d.All the cases reached complete remission (CR).Of the12cases3relapsed in re-cent period and2in remote period.2cases of solid tumor and1case acute leukemia developed second malignancy after8,14and15months respectively.The recurrent rate was42%,The overall survival rate was30%mean survival time were7.5±5.1years.Con clu sion ABTM in the treatment of malignant solid tumor and acute leukemia has rela-tively favorable short-term result and little clinical risk,but had high relapse rate and the risk of sec-ond malignancy.